In the affluent world, mortality from CHD for women is 10-12 times more common than Breast cancer or Cervical cancer. My impression is that most women are not aware of that. Screening systems for the latter two conditions have been operating for decades.Enthusiasm for these approaches are understandable, based on the presumption that the earlier detection will automatically lead to more effective treatment. Well like most aspects of medicine, it rarely is as simple as that.How much screening, at what age, with what test or tests is required to detect one patient, at what cost and the effectiveness of the treatment.Is there any point in screening for disease that can’t be treated or treated with little success?Should we be screening for diseases that are self inflicted? If avoidance is feasible, should most effort be directed there?Like vaccination for the Papilloma virus, involved in much cervical cancer.How effective will it be?
Can we screen for CHD in women and will it be effective?I believe the answer there is yes on both counts, because we can effectively prevent CHD and arrest its progress, as well as treatments that can help postpone the death certificate, but not cure.Slogans like save lives is used casually in and about medicine, but no ones life is ‘saved’, we would all live forever. It seems in evolution, the factors that influenced the origins and developement of CHD, in women and men, were nutritionally similar. As the CHD epidemic played out in the 20th century up to the 1980-90’s, it was apparent to all in Cardiology and Medicine, women appeared pre-menopause to be ‘protected’ from CHD, as the prevalence and mortality was markedly less than males. Post menopause women’s numbers in CHD approached that of men. Was the female hormone a ‘protective’ factor?Were males given female hormone for other reasons, ‘protected’ also?Did male eunuchs develope CHD?The numbers were too small for meaningful interpretation. It seemed reasonable with this association evidence, to replace female hormone post-menopause, a ‘safe’hormone to attempt to reduce CHD for women at that stage in their life biology. My biological law of change, progress, emerged at this stage and so it became apparent that women given female hormone developed ‘more’ cardiovascular disease. This data has been disputed and it has been claimed there was evidence of ‘protection’ from CHD with time. The longer the treatment, the effectiveness kicked in.No one is prepared to take a clinical risk now. The increased risk was not forseen; it did not appear to make patho-physiological sense. So was female hormone ‘protective’ for CHD after all?
The pre and post menopause data is interesting for a variety of reasons. For me it was but another nail in the coffin of Keys, ‘Lipid Hypothesis’ . To give his hypothesis any credence, he would have to prove women before menopause, consumed little or no cholesterol and saturated fat, then as if under some circadian clock, commenced the consumption of the poisons, cholesterol and saturated fat post menopause!Did female hormone control the taste buds for the two poisons, their digestion, absorption? As the consumption of processed CHO , sugar and fructose grew, OWOB, DM and hypertension did too with no gender selection.The selective effect of female hormone lessened. It gets like a Monty Python skit, the more time you spend on it.
The pre and post menopause features have been disturbed somewhat since the 1980’s, as more women smoked, drank alcohol, became over weight, obese, diabetic and some would say male identified. What is encouraging, is all these risk factors for CHD are reversible, preventable.There is too much confusing advice on the Internet now and too much masquerading as authorative, evidence based.The female community can conduct its own screening program by visiting their family doctor, obtain advice and or help on avoiding smoking, excess alcohol consumption; any reduction helps. Have their weight, waist/hip measured with blood levels of casual glucose, Hb A1c, CRP, with lipid TG and HDL. This will give your doctor valuable data on your risk state for CHD. Your doctor may take the opportunity to measure other factors in your blood too. CHD kills the individual, not risk factors. Now your ‘screening’ is complete and you can independently or with your doctor deal with smoking, alcohol, all processed CHO and sucrose sugar, with fructose sugar hidden in your processed food and beverages.Your therapy could be as simple as avoiding processed CHO and sucrose, fructose sugars. A visit to your doctor in three months will confirm your ‘turnaround’ and project you on a journey avoiding coronary heart disease.Its never too late to start, because we have evidence that this works effectively for those who have established CHD too.
Features in our evolution for those that study it, puzzle, confuse and leave us without explanations. Examples; why is there a male and female homosapiens?Its not so males can become CEO’s, its to ensure the survival of the species by reproduction, I can’t think of another reason!The ‘dimorphic’ anatomical phenotypes for men and women, arose for a reason during adaptive evolution. Is there a reason women pre-menopause largely avoided CHD, particularly if they have no risk factors?Perhaps that is the reason, women of child bearing age, much more commonly, consciously and unconsciously ,did not commit to the known risk factors. Was this an innate adaptive feature of women during their child bearing years, to effect an epigenetic enviroment for their progeny and their future disease avoidance? This type survival behaviour is seen in other species for maternal and progeny well being.
For the last 3-4 decades, the female has increasingly adopted the CHD risk factors. Is this a product of too much male identifying?Women have always known bread, cake, biscuits and puddings increased their weight Smoking and alcohol were non-feminine.What has been behind the change in women’s behavior?This is a maladaption and has biological consequences for the next and subsequent generations. Its the reason I describe the female of child bearing age as ‘precious’ biologically and I don’t believe they are aware of that.Medically it is fundamental female physiology that can convert to pathology. Because of the design of economic and social systems and the distortion of some female perspectives, with a biologically ignorant male autocracy, we do not really know the biological quality of the progeny. So screening for asymptomatic and symptomatic CHD at your family doctor, should be supported by the state financially and for the well being of future generations. Is it 10-12 times more important than screening for breast and cervical cancer?Patho-Biology is not as simple as that, but I feel strongly there is a case to be made, to screen for CHD risk factors in female teenagers and women of any age.